Hunter J M, Jaeger S H
Orthop Clin North Am. 1977 Apr;8(2):473-89.
The staged tendon grafting technique has definite advantages in reconstructive hand surgery. The benefits are realized in the more severely injured flexor tendon systems (Boyes' grades 2 to 4). The results obtained in these cases compare favorably with those achieved by primary tendon grafting in less severe grade 1 cases. This is made possible for the following two reasons: First, the inert nature of the implant allows numerous auxiliary procedures to be done at stage I, such as digital neurography, osteotomy, capsulotomy, scar resection, and pulley reconstruction. This can be done without fear of profuse formation of adhesions. Second, the passive gliding of the implant forms a pseudosynovial sheath, which provides a nutritive and physiologic bed for the autograft tendon at stage II. The operative technique has been presented and the postoperative care has been outlined. It cannot be overstressed that a good working relationship between the surgeon, hand therapist, and patient is of paramount importance to the success of the final result. Work on a prototype active gliding tendon prosthesis is described with details of the concepts and biomaterials involved in its development.
分期肌腱移植技术在手部重建手术中具有明显优势。在损伤更严重的屈肌腱系统（博伊斯2至4级）中能体现出这些益处。这些病例所取得的结果与在较轻的1级病例中进行一期肌腱移植所取得的结果相比毫不逊色。这基于以下两个原因得以实现：其一，植入物的惰性使得在第一阶段可以进行许多辅助手术，如指神经探查、截骨术、关节囊切开术、瘢痕切除术和滑车重建。这样做不用担心大量粘连的形成。其二，植入物的被动滑动形成一个假滑膜鞘，在第二阶段为自体移植肌腱提供营养和生理床。文中介绍了手术技术并概述了术后护理。必须着重强调的是，外科医生、手部治疗师和患者之间良好的工作关系对于最终结果的成功至关重要。文中描述了一种原型主动滑动肌腱假体的研制工作，详细介绍了其研发过程中涉及的概念和生物材料。
